| NPI | 1649935503 |
|---|---|
| Former Name | KATIE THERESA MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-194290) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182724) |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2023-10-05 |